Search

Abstract Groundwater resource management and development should be done sustainably, which calls for accurate assessment based on new methods and scientific principles. There is an increasing demand for potable water supplies, to meet the woefully inadequate domestic water needs in the Batcham municipality (west of Cameroun). The dearth of knowledge on sustainable management of water resources is to blame for this predicament. As integrated methodologies are not used in groundwater exploration programs, the current problem has gotten worse. Innovative scientific principles of groundwater resource exploration are required to effectively counteract the non-rationalization of water and the problem of unacceptable failure rates in drilled water borehole development. This will improve the appropriate and sustainable use of these resources. Therefore, the goal of this research is to map groundwater potential zones by utilizing readily available datasets and remote sensing (RS), GIS, Frequency Ratios (FR), and multi-criteria analysis (AHP) techniques. The database used is made up of geological data, hydroclimatic data, well data, and satellite images. Each of the methods used is based on the study of the relationships between the factors controlling the groundwater potential. Among these factors, ten (10) were retained based on previous work; these are slope, elevation, land use, land cover, lineament density, drainage density, topographic wetness index, curvature, geology, rainfall, and the static water level. The AHP allowed, according to the user's expertise, to assign weights to each factor controlling the water potential. The FR made it possible to study the relationships linking each variable with high flow rates. The thematic layers obtained were integrated into a GIS environment to generate the groundwater potential map. Four classes of groundwater potential have been identified: bad, moderate, good, and excellent. The bad classes represent 8.32% and 11.21%; moderate 36.57% and 28.70%; good 43.55% and 38.93%; and excellent 11.56% and 21.16%, for the AHP and FR models, respectively. The overlying of wells with high flow rates on areas of excellent groundwater potential shows perfect concordance, which validated the final map. Likewise, the resulting map was validated by sensitivity curve analysis, and the receiver operating characteristic (ROC) curve from which result accuracy was obtained is 70.63% and 80.28% for the AHP method and FR method, respectively. Finally, the FR model outperformed the AHP model in terms of performance and it is possible to use these dependable models to describe groundwater potential zones in the other regions of Cameroon.

Abstract Appropriate environment management requires an understanding of how mining activity alters environmental characteristics and how those changes affect an area. Therefore, to reduce the adverse effects of mining activity on the land, it becomes crucial to have relevant information about responses to environmental degradation. This study aims to assess the impact of semi-mechanised and artisanal mining activities on the land cover using remote sensing data and photogrammetric analysis, in the Mbale locality, Northern Cameroon. For this purpose, the maximum likelihood classification algorithm of the supervised classification method combined with field surveys was used to map environmental changes, based on Sentinel-2 images of 2019, 2021, and 2023. Normalized Difference Vegetation Index (NDVI), Normalised Difference Water Index (NDWI), Brithness index (BI), and Soil crust index (SCI), were calculated to assess changes in vegetation, bare soil, water body, and exploited area. The orthophoto obtained from photogrammetric processing was performed to outline river network change through visual interpretation techniques and to calculate the volume of pits created by mining. The result of classified images indicated that vegetation cover decreased by 11.74% over the studied years. However, bare soil and exploited areas increased by 9.2% and 5.4% respectively. The calculated spectral indices show that between 2019 and 2023 the locality of Mbale considerably lost its vegetation cover, in favor of bare soil. The color of the soil and the granulometric size of the topsoil have also changed. The photogrammetry analysis highlighted the deviation of the main river and estimated the volume of pits created by mining activity to 22188.7 m3. The mining activities caused a loss of the vegetation cover, generated big pits, and multiple deviations of the Lom River from its natural course, which have a substantial negative influence on the ecosystem. Such data can be used for long-term environmental management, reclamation and rehabilitation monitoring, and mining area restoration.

Breech presentation is a risk factor for poor birth outcomes. Guidance for safest mode of delivery in breech presenting full term pregnancies is available but there is a lack of evidence on the optimal mode of delivery in breech presenting preterm spontaneous births. The aim of this study is to evaluate the causal effect of mode of delivery on extended perinatal death (EPD) in this population using a trial emulation. Randomized experiments are the gold standard for estimating causal effects; however, previous attempts to conduct them in this context has resulted in recruitment challenges. Causal inference methods provide a framework for drawing causal conclusions from observational data. A trial emulation aims to overcome limitations common to observational studies by specifying core components of a randomized trial using observational data. Our trial emulation uses national Scottish health data to identify an eligible study sample and adjust for confounding characteristics between groups undergoing caesarean and vaginal deliveries to simulate randomized assignment of mode of delivery. We were able to estimate the per-protocol impact of caesarean delivery on EPD. Our data, containing all recorded potentially eligible births in Scotland between 1997 and 2019, was provided by eDRIS in a trusted research environment. After applying our eligibility criteria, our data contained 3,457 birth records, (2,361 c-section and 1,096 vaginal deliveries). There were 212 EPDs (1.7% (39) of c-sections and 16% (173) of vaginal deliveries). Our preliminary results suggest that caesarean delivery reduces the odds of EPD by 73% among breech presenting spontaneous preterm births.

Pregnancy-related research using routinely collected data is increasing. Electronic Health Records (EHR) are a robust resource because they can provide information on a large population of pregnant women covering prolonged periods at a reasonable cost. Moreover, information is collected prospectively and is thus free from recall bias. However, these data sources also present challenges. Information is gathered for clinical purposes and often recorded in different datasets (prescriptions, hospital admission, demography, birth records, etc.). Therefore, a significant data management effort must be made to convert all the information into structured and meaningful datasets in which identifying the timing of conception, outcomes of interest, multiple pregnancies, and interpregnancy periods can easily be done. In this study, we linked Scottish Maternity Records between 2007 and 2021 (1,575,153 pregnancies, 493,629 women) to demographics data, datasets with International Classification of Diseases (ICD) diagnostic codes for all inpatient stays and day cases in hospitals, and Prescribing Information System (PIS) for data on all medications from primary care. After combining these datasets using R codes, we developed a simple tree-based algorithm that visually represents each woman at each pregnancy and the related health conditions. Presenting data in this way helps identify relevant clinical questions and the temporal relation of different pregnancies. As an example, we identified the progression of multimorbidity through pregnancies and characterised how multimorbidity changes from one pregnancy to another, considering the woman's health conditions and social class.

The study zone (A) located in the Koubou Gold district is situated between latitudes 4° 36’ to 4° 42’ N and longitudes 14° 08’ to 14° 11’ E, composing of mostly Gneiss and Granodiorite bed rocks. To determine the relationship between gold and selected pathfinder elements (As, Mo, Ag, Sn, Sb, Te, W, Bi, Ni, Cu, Sb, Nb, Ta, Fe, Mn, Cu, Zn, Ni, and Pb) in the laterite soils of the Koubou gold district, East region of Cameroon, a lithogeochemical dataset from the laterites were utilized. The lithogeochemical dataset were realized through the inductively coupled plasma mass spectrometry (ICP-MS) method, while multi-statistical methods of factor analyses, principal component analyses and hierarchical clustering employed to show the relationship between the gold mineral and selected pathfinder minerals. The gold (Au) has a close relation with Bismuth (Bi) while also been related to other elements such as Mn, Ni, Nb, Sn and Ti

The alluvial material in the two PITs of the Mayo Sina in the southern part of Chad, were subjected to a geochemical analysis in order to determine the source rock lithological composition, tectonic context, degree of weathering, type of climate at the period of weathering, and cycles of sedimentation and maturity. Plotting source lithology charts with values of La/Sc, Th/Sc, La/Co, and Cr/Th indicated that the sediments originated from a felsic source rock composition. The Enrichment of LREE/HREE and a negative chondrite Eu anomaly confirm the felsic source rock composition. A passive tectonic context for the source rock of the sediments is revealed by binary charts (SiO2 versus K2O/Na2O) in conjunction with innovative discrimination plots (DF 1 and DF 2 (Arc-Rift-Col)M1, DF (A-P)M, and DF (A-P)MT). The exceptional degree of plagioclase removal and weathering is demonstrated by the results of the Plagioclase Index of Alteration (PIX) and Chemical Index of Alteration (CIX). The proportion of SiO2/Al2O3 and the new index of compositional variation (ICVnew), which exclude iron and calcium oxides from the formula, indicate that the sediments are immature to mature. Schematic representations of K2O/Na2O ratio indicate that the sediments have undergone both primary to secondary phases of sedimentation.

Abstract Background The consequences of cancer on working until retirement age remain unclear. This study aimed to analyse working life considering all possible labour market states in a sample of workers after sickness absence (SA) due to cancer and to compare their working life paths to those of a sample of workers without SA and with an SA due to other diseases. Methods This was a retrospective dynamic cohort study among social security affiliates in Catalonia from 2012–2018. Cases consisted of workers with an SA due to cancer between 2012–2015 (N = 516) and were individually age- and sex-matched with those of affiliates with an SA due to other diagnoses and workers without an SA. All workers (N = 1,548, 56% women) were followed up from entry into the cohort until the end of 2018 to characterise nine possible weekly labour states. Sequence analysis, optimal matching, and multinomial logistic regression were used to identify and assess the probability of future labour market participation patterns (LMPPs). All analyses were stratified by sex. Results Compared with workers with an SA due to cancer, male workers with no SA and SA due to other causes showed a lower probability of being in the LMPP of death (aRRR 0.02, 95% CI: 0.00‒0.16; aRRR 0.17, 95% CI: 0.06‒0.46, respectively) and, among women, a lower probability of permanent disability and death (aRRR 0.24, 95% CI: 0.10‒0.57; aRRR 0.39, 95% CI: 0.19‒0.83, respectively). Compared to workers with SA due to cancer, the risk of early retirement was lower among workers with no SA (women, aRRR 0.60, 95% CI: 0.22‒1.65; men, aRRR 0.64, 95% CI: 0.27‒1.52), although these results were not statistically significant. Conclusions Workplaces, many of which have policies common to all diagnoses, should be modified to the needs of cancer survivors to prevent an increasing frequency of early retirement and permanent disability when possible. Future studies should assess the impact of cancer on premature exit from the labour market among survivors, depending on cancer localisation and type of treatment.

Decapod crustaceans provide a valuable food source worldwide, both through wild capture and captive rearing. They are also used extensively in scientific research, both as subjects for the investigation of basic biological processes and as model organisms for the detection of environmental changes. There is now an increasing acceptance that decapod crustaceans are sentient, and legislation is being introduced in numerous countries to ensure crustacean welfare when they are harvested or held captive. Moreover, methods for the humane slaughter of these animals are being developed, and of these electrical stunning is a prime candidate. Optimisation of electrical stunning is underway for a range of commercially-exploited or scientifically-important species, and the present study contributes to that process by examining further crab (Carcinus maenas) and lobster (Homarus gammarus) species using a rigorous neurophysiological approach. By recording nerve activity in both the central and peripheral nervous systems, we have found that electrical stunning with a standard commercial instrument arrests nerve activity in both these species at all levels: sensory, motor and central, rendering the animals neurologically insensible. This methodology is the most direct and effective way to establish if insensibility is successfully achieved. However, ultimately the routine monitoring of effective stunning in commercial and laboratory settings will have to depend on simple, yet reliable physiological or behavioural indicators, following their calibration against neurological methods. Monitoring heartbeat is used widely to establish metabolic activity, locomotory performance, agonistic interactions and responses to environmental conditions. We have therefore assessed the potential to use cardiac activity as an indicator for the state of sensibility. We recorded the heartbeat in both C. maenas and H. gammarus before and after electrical stunning, but find that in many cases even though nerve activity has ceased both centrally and peripherally, cardiac activity actually continues (though at a reduced rate) for a substantial time (>1h). The heartbeat is therefore not a reliable indicator of the state of sensibility, making it an unsuitable indicator of effective stunning. Possible reasons for these findings, and ways to validate behavioural measures that may be more appropriate for routinely establishing effective electrical stunning, are discussed.

Abstract Introduction Teriflunomide is a once-daily oral immunomodulator approved for relapsing forms of multiple sclerosis (MS) or relapsing–remitting multiple sclerosis (RRMS; depending on the local label), based on extensive evidence from clinical trials and a real-world setting on efficacy, tolerability and patient-reported benefits. The TERICARE study assessed the impact of teriflunomide treatment over 2 years on health-related quality of life (HRQoL) and some of the most common and disabling symptoms of MS, such as fatigue and depression. Methods This prospective observational study in Spain included RRMS patients treated with teriflunomide for ≤ 4 weeks. The following patient-reported outcomes (PROs) were collected at baseline and every 6 months for 2 years: the 29-item Multiple Sclerosis Impact Scale version 2 (MSIS-29), the 21-item Modified Fatigue Impact Scale (MFIS-21), the Beck Depression Inventory (BDI-II), the Short Form (SF)-Qualiveen and the Treatment Satisfaction Questionnaire for Medication v1.4 (TSQM). Annualised relapse rate (ARR), disability progression according to the Expanded Disability Status Scale (EDSS), and no evidence of disease activity (NEDA-3) were also assessed. Results A total of 325 patients were analysed. Patients had a mean (SD) age of 43.2 years (10.4), a mean baseline EDSS score of 1.75 (1.5), a mean number of relapses in the past 2 years of 1.5 (0.7), and 64% had received prior disease-modifying therapy (DMT). Patients showed significant improvements in the psychological domain of MSIS-29 from 35.9 (26.6) at baseline to 29.4 (25.5) at 18 months (p = 0.004) and 29.0 (24.6) at 24 months (p = 0.002). Levels of fatigue and depression were also reduced. After 2 years of treatment with teriflunomide, ARR was reduced to 0.17 (95% CI 0.14–0.21) from the baseline of 0.42 (95% CI 0.38–0.48), representing a 60.1% reduction. Mean EDSS scores remained stable during the study, and 79.9% of patients showed no disability progression. 54.7% of patients achieved NEDA-3 in the first 12 months, which increased to 61.4% during months 12–24. Patients reported increased satisfaction with treatment over the course of the study, regardless of whether they were DMT naive or not. Conclusion Teriflunomide improves psychological aspects of HRQoL and maintains low levels of fatigue and depression. Treatment with teriflunomide over 2 years is effective in reducing ARR and disability progression.

Abstract Background Primary care electronic health records (EHR) are widely used to study long-term conditions in epidemiological and health services research. Therefore, it is important to understand how well the recorded prevalence of these conditions in EHRs, compares to other reliable sources overall, and varies by socio-demographic characteristics. We aimed to describe the prevalence and socio-demographic variation of cardiovascular, renal, and metabolic (CRM) and mental health (MH) conditions in a large, nationally representative, English primary care database and compare with prevalence estimates from other population-based studies. Methods This was a cross-sectional study using the Clinical Practice Research Datalink (CPRD) Aurum primary care database. We calculated prevalence of 18 conditions and used logistic regression to assess how this varied by age, sex, ethnicity, and socio-economic status. We searched the literature for population prevalence estimates from other sources for comparison with the prevalences in CPRD Aurum. Results Depression (16.0%, 95%CI 16.0–16.0%) and hypertension (15.3%, 95%CI 15.2–15.3%) were the most prevalent conditions among 12.4 million patients. Prevalence of most conditions increased with socio-economic deprivation and age. CRM conditions, schizophrenia and substance misuse were higher in men, whilst anxiety, depression, bipolar and eating disorders were more common in women. Cardiovascular risk factors (hypertension and diabetes) were more prevalent in black and Asian patients compared with white, but the trends in prevalence of cardiovascular diseases by ethnicity were more variable. The recorded prevalences of mental health conditions were typically twice as high in white patients compared with other ethnic groups. However, PTSD and schizophrenia were more prevalent in black patients. The prevalence of most conditions was similar or higher in the primary care database than diagnosed disease prevalence reported in national health surveys. However, screening studies typically reported higher prevalence estimates than primary care data, especially for PTSD, bipolar disorder and eating disorders. Conclusions The prevalence of many clinically diagnosed conditions in primary care records closely matched that of other sources. However, we found important variations by sex and ethnicity, which may reflect true variation in prevalence or systematic differences in clinical presentation and practice. Primary care data may underrepresent the prevalence of undiagnosed conditions, particularly in mental health.

Abstract Background Multimorbidity, smoking status, and pregnancy are identified as three risk factors associated with more severe outcomes following a SARS-CoV-2 infection, thus vaccination uptake is crucial for pregnant women living with multimorbidity and a history of smoking. This study aimed to examine the impact of multimorbidity, smoking status, and demographics (age, ethnic group, area of deprivation) on vaccine hesitancy among pregnant women in Wales using electronic health records (EHR) linkage. Methods This cohort study utilised routinely collected, individual-level, anonymised population-scale linked data within the Secure Anonymised Information Linkage (SAIL) Databank. Pregnant women were identified from 13th April 2021 to 31st December 2021. Survival analysis was employed to examine and compare the length of time to vaccination uptake in pregnancy by considering multimorbidity, smoking status, as well as depression, diabetes, asthma, and cardiovascular conditions independently. The study also assessed the variation in uptake by multimorbidity, smoking status, and demographics, both jointly and separately for the independent conditions, using hazard ratios (HR) derived from the Cox regression model. Results Within the population cohort, 8,203 (32.7%) received at least one dose of the COVID-19 vaccine during pregnancy, with 8,572 (34.1%) remaining unvaccinated throughout the follow-up period, and 8,336 (33.2%) receiving the vaccine postpartum. Women aged 30 years or older were more likely to have the vaccine in pregnancy. Those who had depression were slightly but significantly more likely to have the vaccine compared to those without depression (HR = 1.08, 95% CI 1.03 to 1.14, p = 0.002). Women living with multimorbidity were 1.12 times more likely to have the vaccine compared to those living without multimorbidity (HR = 1.12, 95% CI 1.04 to 1.19, p = 0.001). Vaccine uptakes were significantly lower among both current smokers and former smokers compared to never smokers (HR = 0.87, 95% CI 0.81 to 0.94, p

Abstract Background Multimorbidity is common in women across the life course. Preterm birth is the single biggest cause of neonatal mortality and morbidity. We aim to estimate the prevalence of multimorbidity in pregnant women and to examine the association between maternal multimorbidity and PTB. Methods This is a retrospective cohort study using electronic health records from the Scottish Morbidity Records. All pregnancies among women aged 15 to 49 with a conception date between 1 January 2014 and 31 December 2018 were included. Multimorbidity was defined as the presence of two or more pre-existing long-term physical or mental health conditions, and complex multimorbidity as the presence of four or more. It was calculated at the time of conception using a predefined list of 79 conditions published by the MuM-PreDiCT consortium. PTB was defined as babies born alive between 24 and less than 37 completed weeks of gestation. We used Generalised Estimating Equations adjusted for maternal age, socioeconomic status, number of previous pregnancies, BMI, and smoking history to estimate the effect of maternal pre-existing multimorbidity. Absolut rates are reported in the results and tables, whilst Odds Ratios (ORs) are adjusted (aOR). Results Thirty thousand five hundred fifty-seven singleton births from 27,711 pregnant women were included in the analysis. The prevalence of pre-existing multimorbidity and complex multimorbidity was 16.8% (95% CI: 16.4–17.2) and 3.6% (95% CI: 3.3–3.8), respectively. The prevalence of multimorbidity in the youngest age group was 10.2%(95% CI: 8.8–11.6), while in those 40 to 44, it was 21.4% (95% CI: 18.4–24.4), and in the 45 to 49 age group, it was 20% (95% CI: 8.9–31.1). In women without multimorbidity, the prevalence of PTB was 6.7%; it was 11.6% in women with multimorbidity and 15.6% in women with complex multimorbidity. After adjusting for maternal age, socioeconomic status, number of previous pregnancies, Body Mass Index (BMI), and smoking, multimorbidity was associated with higher odds of PTB (aOR = 1.64, 95% CI: 1.48–1.82). Conclusions Multimorbidity at the time of conception was present in one in six women and was associated with an increased risk of preterm birth. Multimorbidity presents a significant health burden to women and their offspring. Routine and comprehensive evaluation of women with multimorbidity before and during pregnancy is urgently needed.

Abstract Background Heterogeneity in reported outcomes can limit the synthesis of research evidence. A core outcome set informs what outcomes are important and should be measured as a minimum in all future studies. We report the development of a core outcome set applicable to observational and interventional studies of pregnant women with multimorbidity. Methods We developed the core outcome set in four stages: (i) a systematic literature search, (ii) three focus groups with UK stakeholders, (iii) two rounds of Delphi surveys with international stakeholders and (iv) two international virtual consensus meetings. Stakeholders included women with multimorbidity and experience of pregnancy in the last 5 years, or are planning a pregnancy, their partners, health or social care professionals and researchers. Study adverts were shared through stakeholder charities and organisations. Results Twenty-six studies were included in the systematic literature search (2017 to 2021) reporting 185 outcomes. Thematic analysis of the focus groups added a further 28 outcomes. Two hundred and nine stakeholders completed the first Delphi survey. One hundred and sixteen stakeholders completed the second Delphi survey where 45 outcomes reached Consensus In (≥70% of all participants rating an outcome as Critically Important). Thirteen stakeholders reviewed 15 Borderline outcomes in the first consensus meeting and included seven additional outcomes. Seventeen stakeholders reviewed these 52 outcomes in a second consensus meeting, the threshold was ≥80% of all participants voting for inclusion. The final core outcome set included 11 outcomes. The five maternal outcomes were as follows: maternal death, severe maternal morbidity, change in existing long-term conditions (physical and mental), quality and experience of care and development of new mental health conditions. The six child outcomes were as follows: survival of baby, gestational age at birth, neurodevelopmental conditions/impairment, quality of life, birth weight and separation of baby from mother for health care needs. Conclusions Multimorbidity in pregnancy is a new and complex clinical research area. Following a rigorous process, this complexity was meaningfully reduced to a core outcome set that balances the views of a diverse stakeholder group.

Abstract Background Maternal multiple long-term conditions are associated with adverse outcomes for mother and child. We conducted a qualitative study to inform a core outcome set for studies of pregnant women with multiple long-term conditions. Methods Women with two or more pre-existing long-term physical or mental health conditions, who had been pregnant in the last five years or planning a pregnancy, their partners and health care professionals were eligible. Recruitment was through social media, patients and health care professionals’ organisations and personal contacts. Participants who contacted the study team were purposively sampled for maximum variation. Three virtual focus groups were conducted from December 2021 to March 2022 in the United Kingdom: (i) health care professionals (n = 8), (ii) women with multiple long-term conditions (n = 6), and (iii) women with multiple long-term conditions (n = 6) and partners (n = 2). There was representation from women with 20 different physical health conditions and four mental health conditions; health care professionals from obstetrics, obstetric/maternal medicine, midwifery, neonatology, perinatal psychiatry, and general practice. Participants were asked what outcomes should be reported in all studies of pregnant women with multiple long-term conditions. Inductive thematic analysis was conducted. Outcomes identified in the focus groups were mapped to those identified in a systematic literature search in the core outcome set development. Results The focus groups identified 63 outcomes, including maternal (n = 43), children’s (n = 16) and health care utilisation (n = 4) outcomes. Twenty-eight outcomes were new when mapped to the systematic literature search. Outcomes considered important were generally similar across stakeholder groups. Women emphasised outcomes related to care processes, such as information sharing when transitioning between health care teams and stages of pregnancy (continuity of care). Both women and partners wanted to be involved in care decisions and to feel informed of the risks to the pregnancy and baby. Health care professionals additionally prioritised non-clinical outcomes, including quality of life and financial implications for the women; and longer-term outcomes, such as children’s developmental outcomes. Conclusions The findings will inform the design of a core outcome set. Participants’ experiences provided useful insights of how maternity care for pregnant women with multiple long-term conditions can be improved.

Este estudio se plantea, en primer lugar, mostrar si el estallido de la pandemia Covid-19 ocasionada por el coronavirus SARS-CoV-2 ha evidenciado deficiencias en cuanto al desarrollo profesional según los propios docentes, en segundo lugar, valorar si esta percepción está vinculada con la participación en formaciones previas de desarrollo profesional docente de diferentes áreas y, por último, valorar si esta percepción está vinculada con diferentes aspectos de la percepción del Desarrollo Profesional Docente. 137 docentes no universitarios participaron en el estudio en el que sus percepciones fueron analizadas mediante correlaciones utilizando Chi Cuadrado, D de Somers y Rho de Spearman como estadísticos de contraste. Los resultados muestran cómo un 93.4% de los profesores no universitarios consideran que la pandemia ha mostrado sus carencias en desarrollo profesional docente y que son los más jóvenes y los que menos formación inicial pedagógica tienen los que más lo han percibido.

We propose a political-ecological approach to community desalination based on our experience installing small desalination plants in three coastal communities in southern Chile. Conceptually, we frame community desalination plants as new hydrosocial assemblages different from large-scale or extractivist desalination, discussing how social participation is key to the community’s reappropriation of nature through desalination plants. We use the literature of scalar politics in water governance as a device for analysing the ongoing political struggles around water and the role that community desalination can play in satisfying the human right to water. Through a multi-method and participatory approach, we demonstrate the situated nature of community desalination development in Chile. We identify three stages in the configuration of the new hydrosocial assemblages: negotiating the installation of the plants, valuing the drinking water produced by the plants, and negotiating to finance their definitive installation as a complementary source of drinking water for these communities. We also show that the community appropriation of these plants depends mainly on the water quality and the institutional arrangements to sustain these small plants over space and time. We analyse how the community scale interacts with municipal, regional, and national scales differently. Finally, we conclude by evaluating, from a hydrosocial perspective, the pros and cons of using this community desalination process to satisfy the human right to water.

The Norway lobster, Nephrops norvegicus, is an important representative of the benthos and also supports valuable fisheries across Europe. Nephrops are susceptible to infection by Hematodinium sp., an endoparasitic dinoflagellate that causes morbidity and mortality. From an epizootiological perspective, the Clyde Sea Area (CSA; west of Scotland) is the best-studied Hematodinium–Nephrops pathosystem, with historical data available between 1988 and 2008. We have revisited this pathosystem by curating and updating prevalence values, differentiating host traits associated with disease exposure and progression, and comparing Hematodinium sp. disease dynamics in the CSA to other locations and to other decapod hosts (Cancer pagurus, Carcinus maenas). Prevalence from a 2018/2019 survey (involving 1739 lobsters) revealed Hematodinium sp. still mounts a synchronized patent infection in the CSA; hence this pathogen can be considered as enzootic in this location. We highlight for the first time that Nephrops size is associated with high severity infection, while females are more exposed to Hematodinium sp. More generally, regardless of the host (Norway lobster, brown and shore crabs) or the geographical area (Ireland, Wales, Scotland), Hematodinium sp. patent infections peak in spring/summer and reach their nadir during autumn. We contend that Hematodinium must be considered one of the most important pathogens of decapod crustaceans in temperate waters.

Multiple sclerosis (MS) arises from a complex interplay between host genetic factors and environmental components, with the gut microbiota emerging as a key area of investigation. In the current study, we used ion torrent sequencing to delve into the bacteriome (bacterial microbiota) and mycobiome (fungal microbiota) of people with MS (pwMS), and compared them to healthy controls (HC). Through principal coordinate, diversity, and abundance analyses, as well as clustering and cross-kingdom microbial correlation assessments, we uncovered significant differences in the microbial profiles between pwMS and HC. Elevated levels of the fungus Torulaspora and the bacterial family Enterobacteriaceae were observed in pwMS, whereas beneficial bacterial taxa, such as Prevotelladaceae and Dialister, were reduced. Notably, clustering analysis revealed overlapping patterns in the bacteriome and mycobiome data for 74% of the participants, with weakened cross-kingdom interactions evident in the altered microbiota of pwMS. Our findings highlight the dysbiosis of both bacterial and fungal microbiota in MS, characterized by shifts in biodiversity and composition. Furthermore, the distinct disease-associated pattern of fungi–bacteria interactions suggests that fungi, in addition to bacteria, contribute to the pathogenesis of MS. Overall, our study sheds light on the intricate microbial dynamics underlying MS, paving the way for further investigation into the potential therapeutic targeting of the gut microbiota in MS management.

Biomonitoring of human populations exposed to chemical substances that can act as potential mutagens or carcinogens, may enable the detection of damage and early disease prevention. In recent years, the comet assay has become an important tool for assessing DNA damage, both in environmental and occupational exposure contexts. To evidence the role of the comet assay in human biomonitoring, we have analysed original research studies of environmental or occupational exposure that used the comet assay in their assessments, following the PRISMA-ScR method (preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews). Groups of chemicals were designated according to a broad classification, and the results obtained from over 300 original studies (n = 123 on air pollutants, n = 14 on anaesthetics, n = 18 on antineoplastic drugs, n = 57 on heavy metals, n = 59 on pesticides, and n = 49 on solvents) showed overall higher values of DNA strand breaks in the exposed subjects in comparison with the unexposed. In summary, our systematic scoping review strengthens the relevance of the use of the comet assay in assessing DNA damage in human biomonitoring studies.

OBJECTIVES/GOALS: We aim to identify neurodevelopment delays among children who were born prematurely. We will also calculate the sensitivity and specificity of the assessment tools used to measure the neurodevelopmental profile in early childhood of children exposed to the Neonatal Intensive Care Unit (NICU). METHODS/STUDY POPULATION: This cross-sectional study will include 100 premature children who were born between 32 to 37 weeks of gestational age and admitted to NICU at the University Pediatric Hospital in Puerto Rico. Their neurodevelopment will be measured with the Bayley III. Statistical analysis will be performed using IBM SPSS Statistics 25.0. Descriptive statistics will be used, normality distributions among all continuous variables, frequency distribution for categorical variables and logistic regressions to test association of GA and neurodevelopment delay. We will use the raw item scores for each domain of the Bayley III assessments to measure internal consistency using Cronbach’s alpha and factor analysis. RESULTS/ANTICIPATED RESULTS: We anticipate identifying the ND among children born prematurely between 32 to 37 weeks of gestational age and who were admitted to NICU at the University Pediatric Hospital in Puerto Rico. We also expect to find if gestational age impacts adversely ND in children who were born between 32 to 37 weeks of gestation. We will be able to assess if lower gestational age will impact global ND in contrast to higher gestational age neurodevelopment delays in one specific area of development. We will also be able to assess the sensitivity and specificity of the Bayley- III. DISCUSSION/SIGNIFICANCE: Premature is a major global health problem with a 12.0% prevalence. We want to promote early identification of ND in a diverse Hispanic Puerto Rican population so we can guide public health decisions and lead research initiatives to improve outcomes in the future or facing prematurity.

Eggshell is a cheap and environmentally friendly waste stream from the food industry, which could be potentially used for different applications in a circular economy scenario. Carbonation of eggshell derived sorbents has been investigated for calcium looping high temperature applications. Nevertheless, the application of these sorbents for direct air capture is yet to be explored in detail. In this work, waste eggshell (ES) and three different ethanol/water treated eggshell samples (E70, E80 and E90) are assessed for direct air capture and compared to limestone. These samples are exposed to ambient air in two distinct conditions. Namely, i) ambient air at 25 °C in a laboratory and ii) refrigerator conditions at 4 °C in order to simulate how these sorbents might perform in different climatic scenarios for varying geographic areas. Carbonation and hydration conversions were calculated for times of ∼ 3000 h. It was found that treating the eggshells with ethanol was key in order to obtain a suitable material for this application. Two of the ethanol-treated samples obtained similar conversions in comparable amounts of time for ambient air conditions, while limestone still performed better in refrigerator conditions.

Introduction Considering the high prevalence of polypharmacy in pregnant women and the knowledge gap in the risk–benefit safety profile of their often-complex treatment plan, more research is needed to optimise prescribing. In this study, we aim to detect adverse and protective effect signals of exposure to individual and pairwise combinations of medications during pregnancy.Methods and analysis Using a range of real-world data sources from the UK, we aim to conduct a pharmacovigilance study to assess the safety of medications prescribed during the preconception period (3 months prior to conception) and first trimester of pregnancy. Women aged between 15 and 49 years with a record of pregnancy within the Clinical Practice Research Datalink (CPRD) Pregnancy Register, the Welsh Secure Anonymised Information Linkage (SAIL), the Scottish Morbidity Record (SMR) data sets and the Northern Ireland Maternity System (NIMATS) will be included. A series of case control studies will be conducted to estimate measures of disproportionality, detecting signals of association between a range of pregnancy outcomes and exposure to individual and combinations of medications. A multidisciplinary expert team will be invited to a signal detection workshop. By employing a structured framework, signals will be transparently assessed by each member of the team using a questionnaire appraising the signals on aspects of temporality, selection, time and measurement-related biases and confounding by underlying disease or comedications. Through group discussion, the expert team will reach consensus on each of the medication exposure–outcome signal, thereby excluding spurious signals, leaving signals suggestive of causal associations for further evaluation.Ethics and dissemination Ethical approval has been obtained from the Independent Scientific Advisory Committee, SAIL Information Governance Review Panel, University of St. Andrews Teaching and Research Ethics Committee and Office for Research Ethics Committees Northern Ireland (ORECNI) for access and use of CPRD, SAIL, SMR and NIMATS data, respectively.

Summary: Carriers of BRCA1 germline pathogenic variants are at substantially higher risk of developing breast and ovarian cancer than the general population. Accurate identification of at-risk individuals is crucial for risk stratification and the implementation of targeted preventive and therapeutic interventions. Despite significant progress in variant classification efforts, a sizable portion of reported BRCA1 variants remain as variants of uncertain clinical significance (VUSs). Variants leading to premature protein termination and loss of essential functional domains are typically classified as pathogenic. However, the impact of frameshift variants that result in an extended incorrect terminus is not clear. Using validated functional assays, we conducted a systematic functional assessment of 17 previously reported BRCA1 extended incorrect terminus variants (EITs) and concluded that 16 constitute loss-of-function variants. This suggests that most EITs are likely to be pathogenic. However, one variant, c.5578dup, displayed a protein expression level, affinity to known binding partners, and activity in transcription and homologous recombination assays comparable to the wild-type BRCA1 protein. Twenty-three additional carriers of c.5578dup were identified at a US clinical diagnostic lab and assessed using a family history likelihood model providing, in combination with the functional data, a likely benign interpretation. These results, consistent with family history data in the current study and available data from ClinVar, indicate that most, but not all, BRCA1 variants leading to an extended incorrect terminus constitute loss-of-function variants and underscore the need for comprehensive assessment of individual variants.

Summary: Background: Understanding and quantifying the differences in disease development in different socioeconomic groups of people across the lifespan is important for planning healthcare and preventive services. The study aimed to measure chronic disease accrual, and examine the differences in time to individual morbidities, multimorbidity, and mortality between socioeconomic groups in Wales, UK. Methods: Population-wide electronic linked cohort study, following Welsh residents for up to 20 years (2000–2019). Chronic disease diagnoses were obtained from general practice and hospitalisation records using the CALIBER disease phenotype register. Multi-state models were used to examine trajectories of accrual of 132 diseases and mortality, adjusted for sex, age and area-level deprivation. Restricted mean survival time was calculated to measure time spent free of chronic disease(s) or mortality between socioeconomic groups. Findings: In total, 965,905 individuals aged 5–104 were included, from a possible 2.9 m individuals following a 5-year clearance period, with an average follow-up of 13.2 years (12.7 million person-years). Some 673,189 (69.7%) individuals developed at least one chronic disease or died within the study period. From ages 10 years upwards, the individuals living in the most deprived areas consistently experienced reduced time between health states, demonstrating accelerated transitions to first and subsequent morbidities and death compared to their demographic equivalent living in the least deprived areas. The largest difference were observed in 10 and 20 year old males developing multimorbidity (−0.45 years (99% CI: −0.45, −0.44)) and in 70 year old males dying after developing multimorbidity (−1.98 years (99% CI: −2.01, −1.95)). Interpretation: This study adds to the existing literature on health inequalities by demonstrating that individuals living in more deprived areas consistently experience accelerated time to diagnosis of chronic disease and death across all ages, accounting for competing risks. Funding: UK Medical Research Council, Health Data Research UK, and Administrative Data Research Wales.

We describe how the water commons agenda has been mobilized by different social groups of Chilean society, including water social movements and indigenous people, and the way it was included in the constitutional debate (2021–2022). Although the draft for the new Constitution was rejected in September 2022, we argue that the water commons agenda is still being mobilized as a socioenvironmental project for the 21st century. Simply put, the water commons agenda does not disappear with the defeat of the proposed new Constitution. It continues to challenge the neoliberalization of nature and water imposed during the Pinochet dictatorship, proposing to create new ways to sustain the territories of life. HIGHLIGHTS Water and social crisis in Chile.; Social movements and indigenous people mobilize both the water commons agenda and the constituent process.; Constituent Convention declares water as a common good.; Proposed Constitution is rejected by citizenship.; Water commons agenda for the 21st century.;

The use of Deep learning techniques in the field of Marine Science has become popular in recent years. For instance, many works propose the application of instance segmentation neural networks (in particular, Mask R-CNN) for detection and classification of fish in underwater images. The performance of these learning-based approaches depends heavily on the volume of data used for training, which, in the case of instance segmentation models for fish detection, implies that human experts must label and mark the shapes of all the fish appearing in a vast amount of underwater images. This is an enormously time-consuming task that we seek to alleviate in this paper. We propose a training strategy that combines manual and semi-automatic annotations. The latter are obtained in a weakly-supervised manner: the bounding box that contains the fish is manually selected, but its shape is automatically obtained thanks to a pretrained encoder-decoder segmentation network. Several popular architectures for this encoder-decoder network are examined. This strategy permits to reduce drastically the annotation cost for instance segmentation, at the expense of a small drop in performance with respect to the use of fully manual annotations. We show that a balance can be achieved between the segmentation performance and the time used to collect the training data by using the proposed strategy.

Abstract Background The number of medications prescribed during pregnancy has increased over the past few decades. Few studies have described the prevalence of multiple medication use among pregnant women. This study aims to describe the overall prevalence over the last two decades among all pregnant women and those with multimorbidity and to identify risk factors for polypharmacy in pregnancy. Methods A retrospective cohort study was conducted between 2000 and 2019 using the Clinical Practice Research Datalink (CPRD) pregnancy register. Prescription records for 577 medication categories were obtained. Prevalence estimates for polypharmacy (ranging from 2+ to 11+ medications) were presented along with the medications commonly prescribed individually and in pairs during the first trimester and the entire pregnancy period. Logistic regression models were performed to identify risk factors for polypharmacy. Results During the first trimester (812,354 pregnancies), the prevalence of polypharmacy ranged from 24.6% (2+ medications) to 0.1% (11+ medications). During the entire pregnancy period (774,247 pregnancies), the prevalence ranged from 58.7 to 1.4%. Broad-spectrum penicillin (6.6%), compound analgesics (4.5%) and treatment of candidiasis (4.3%) were commonly prescribed. Pairs of medication prescribed to manage different long-term conditions commonly included selective beta 2 agonists or selective serotonin re-uptake inhibitors (SSRIs). Risk factors for being prescribed 2+ medications during the first trimester of pregnancy include being overweight or obese [aOR: 1.16 (1.14–1.18) and 1.55 (1.53–1.57)], belonging to an ethnic minority group [aOR: 2.40 (2.33–2.47), 1.71 (1.65–1.76), 1.41 (1.35–1.47) and 1.39 (1.30–1.49) among women from South Asian, Black, other and mixed ethnicities compared to white women] and smoking or previously smoking [aOR: 1.19 (1.18–1.20) and 1.05 (1.03–1.06)]. Higher and lower age, higher gravidity, increasing number of comorbidities and increasing level of deprivation were also associated with increased odds of polypharmacy. Conclusions The prevalence of polypharmacy during pregnancy has increased over the past two decades and is particularly high in younger and older women; women with high BMI, smokers and ex-smokers; and women with multimorbidity, higher gravidity and higher levels of deprivation. Well-conducted pharmaco-epidemiological research is needed to understand the effects of multiple medication use on the developing foetus.

Cultivar contamination is a common issue in commercial cranberry production. Unknown or unwanted cranberry genotypes are found in commercial cranberry beds that are intended to be a single uniform genotype. Identification of contamination and the impact of contamination remain crucial issues for the cranberry industry to maintain long-term high productivity. To address this issue, tissue samples were taken from the former commercial beds of the new Wisconsin Cranberry Research Station (WCRS) for genetic fingerprinting analysis. The goal of this collection was to analyze the 10 beds for genetic uniformity to determine if any should be maintained or replaced, and to assess the accuracy of visual perception of genetic contamination in the field. A total of 288 DNA samples were collected in the 10 cranberry beds, and the ‘Stevens’ cultivar represented 180 samples or 69% of the 261 samples expected to be ‘Stevens.’ Therefore, the genotype contamination in the ‘Stevens’ beds was 31% overall. Overall, visual differentiation was accurate in distinguishing between genotypes and detecting large areas of contamination. A yield analysis was conducted along with the genotypic uniformity assessments, and a significant correlation was found between the 2017 yield of the beds and their level of genetic contamination. This study demonstrates the usefulness of genetic uniformity testing and mapping for cranberry bed management and renovation decision-making.

In subarachnoid hemorrhage following traumatic brain injury (TBI), the high intracisternal pressure drives the cerebrospinal fluid into the brain parenchyma, causing cerebral edema. Basal cisternostomy involves opening the basal cisterns to atmospheric pressure and draining cerebrospinal fluid in an attempt to reverse the edema. We describe a case of basal cisternostomy combined with decompressive craniectomy. A 35-year-old man with severe TBI following a road vehicle accident presented with acute subdural hematoma, Glasgow coma scale score of 6, fixed pupils and no corneal response. Opening of the basal cisterns and placement of a temporary cisternal drain led to immediate relaxation of the brain. The patient had a Glasgow coma scale score of 15 on postoperative day 6 and was discharged on day 10. We think basal cisternostomy is a feasible and effective procedure that should be considered in the management of TBI.

Abstract There is a need for better understanding of the risk of thrombocytopenic, haemorrhagic, thromboembolic disorders following first, second and booster vaccination doses and testing positive for SARS-CoV-2. Self-controlled cases series analysis of 2.1 million linked patient records in Wales between 7th December 2020 and 31st December 2021. Outcomes were the first diagnosis of thrombocytopenic, haemorrhagic and thromboembolic events in primary or secondary care datasets, exposure was defined as 0–28 days post-vaccination or a positive reverse transcription polymerase chain reaction test for SARS-CoV-2. 36,136 individuals experienced either a thrombocytopenic, haemorrhagic or thromboembolic event during the study period. Relative to baseline, our observations show greater risk of outcomes in the periods post-first dose of BNT162b2 for haemorrhagic (IRR 1.47, 95%CI: 1.04–2.08) and idiopathic thrombocytopenic purpura (IRR 2.80, 95%CI: 1.21–6.49) events; post-second dose of ChAdOx1 for arterial thrombosis (IRR 1.14, 95%CI: 1.01–1.29); post-booster greater risk of venous thromboembolic (VTE) (IRR-Moderna 3.62, 95%CI: 0.99–13.17) (IRR-BNT162b2 1.39, 95%CI: 1.04–1.87) and arterial thrombosis (IRR-Moderna 3.14, 95%CI: 1.14–8.64) (IRR-BNT162b2 1.34, 95%CI: 1.15–1.58). Similarly, post SARS-CoV-2 infection the risk was increased for haemorrhagic (IRR 1.49, 95%CI: 1.15–1.92), VTE (IRR 5.63, 95%CI: 4.91, 6.4), arterial thrombosis (IRR 2.46, 95%CI: 2.22–2.71). We found that there was a measurable risk of thrombocytopenic, haemorrhagic, thromboembolic events after COVID-19 vaccination and infection.

Sediment quality and trace metal accumulation are two of the most pressing issues facing the aquatic ecosystem around the world. Twenty-four (24) samples of stream sediments were collected along the Dibamba River, in the economic and industrial capital of Cameroon, to judge the trace metal levels in this river flowing near the city of Douala. Trace metal concentrations were disclosed with an ICP-MS on two different grain size fractions (very fine-grained sand and clay). The sediments indicate possible adverse effects of trace metals on surrounding biota as elements like Cr, Cu, Ni, Zn, Pb, and Hg show positive enrichment of greater than 1 when compared to background values from the upper continental crust (UCC) and sediment quality factors such as TEL (threshold effects level), PEL (probable effects level), ERL (effects range low), and ERM (effects range medium) values. The sediments show values of Degree of contamination (DC = 2–4), Pollution load index (PI = 1–2), and individual potential risk (EI = 92–219) indicating moderate pollution and ecological risk. Statistical and multivariate analyses point to both anthropogenic and geogenic sources for the heavy metals in the Dibamba stream sediments. The geogenic origin of the heavy metals is linked to the weathering of gneiss and migmatite found in the river banks. This study found low to mild levels of metal pollution and toxicity in the sediment, but it also warned that the continued development of nearby industries and businesses, the provision of transportation services, and waste disposal activities could result in a gradual outflow and accumulation of metals in the sediment, endangering the aquatic ecosystem.

Carcinogenic chemicals, or their metabolites, can be classified as genotoxic or non-genotoxic carcinogens (NGTxCs). Genotoxic compounds induce DNA damage, which can be detected by an established in vitro and in vivo battery of genotoxicity assays. For NGTxCs, DNA is not the primary target, and the possible modes of action (MoA) of NGTxCs are much more diverse than those of genotoxic compounds, and there is no specific in vitro assay for detecting NGTxCs. Therefore, the evaluation of the carcinogenic potential is still dependent on long-term studies in rodents. This 2-year bioassay, mainly applied for testing agrochemicals and pharmaceuticals, is time-consuming, costly and requires very high numbers of animals. More importantly, its relevance for human risk assessment is questionable due to the limited predictivity for human cancer risk, especially with regard to NGTxCs. Thus, there is an urgent need for a transition to new approach methodologies (NAMs), integrating human-relevant in vitro assays and in silico tools that better exploit the current knowledge of the multiple processes involved in carcinogenesis into a modern safety assessment toolbox. Here, we describe an integrative project that aims to use a variety of novel approaches to detect the carcinogenic potential of NGTxCs based on different mechanisms and pathways involved in carcinogenesis. The aim of this project is to contribute suitable assays for the safety assessment toolbox for an efficient and improved, internationally recognized hazard assessment of NGTxCs, and ultimately to contribute to reliable mechanism-based next-generation risk assessment for chemical carcinogens.

Esta investigación da cuenta de algunas concepciones y actitudes que posee el estudiantado de carreras de las áreas de educación, ciencias sociales y ciencias jurídicas de la Universidad de Concepción, sobre algunos aspectos vinculados a la participación política de las mujeres en Chile. Ello se ha obtenido a partir de los resultados de una encuesta aplicada a estudiantes de primer año. Tales resultados demostraron que al iniciar sus estudios universitarios valoran positivamente la consagración formal de la participación política de las mujeres, consideran un deber del Estado garantizar la igualdad de oportunidades y manifiestan desconfianza en los partidos políticos y en el Congreso Nacional. Sin embargo, a la hora de las oportunidades, la confianza tiende a ser mayor en los hombres para depositar responsabilidades de carácter político, lo que introduce la necesidad de avanzar desde la formalidad del buen discurso sobre igualdad a la acción práctica en política.

Black shales are highly enriched in essential elements containing critical information on metallic richness and paleoclimatic imprints during deposition. The Cretaceous period marks the age of Basin formation from which the Mamfe Basin was formed from the Albian to Cenomanian. The purpose of this study is to investigate the geochemical behaviour of the shales in the Mamfe Basin and their paleoclimatic and metallogenic significance. Twenty-five representative shale samples were collected from seven sites outcrops in the Mamfe Basin. The major and trace elements composition in the shale samples were analysed using Inductively Coupled Plasma-Atomic Emission Spectrometry (ICP-AES) and Inductively Coupled Plasma Mass Spectrometry (ICP-MS). In comparison with standard values for metalliferous shales, the shales from the Mamfe Basin are enriched in Boron (B), with only few samples enriched in Li, Rb, Cu, Pb and Zn. The Aluminium module (Alm) and ternary diagram plotted from Al–Fe–Mn shows that all the shales are considered as terrigenous sediments with only 02 samples (08%) falling within the zone of metalliferous sediments. The paleoclimatic characteristics that were inferred from the C-values (0.3–3.1), Sr/Cu (0.6–8.9), Sr/Ba (0.1–2.8), Rb/Sr (0.3–0.9), Fe/Mn (1.8–180), Al/Mg (0.31–31) and Mg/Ca (0.05–16.4) data of the shales in the Mamfe Basin indicate a that the climate that existed during source area weathering ranged from a sub humid to a more humid climate with few samples ≤5% displaying arid climate.

Chemical analyses were carried out on clastic sedimentary rocks in Kompina (N'kapa Formation of the NW, Douala Basin, West Africa) to disclosed the composition of their source rock, characterised their tectonic domains, decipher the intensity of the past weathering, sedimentary cycles and maturity using concentrations of major oxides, REES and trace elements. Provenance diagram constructed from ratios of La/Co, La/Sc, Th/Sc, Cr/Th and from binary diagrams of Zr vs TiO2 and AL2O3 vs TiO2, disclosed a felsic rock composition as the source rock of the Kompina clastic rocks. The felsic source rock composition designated for the studied clastic materials is also supported by LREE enrichment over HREE and a negative europium anomaly on chondrite calculation and diagram. New discriminant functions diagrams to delineate between active and passive domains such as DF 1&2(Arc-Rift-Col)M1, DF1&2(Arc-Rift-Col)M2 combined with diagrams of DF(A-P)M, DF(A-P)MT label a passive tectonic setting characteristics for the source rock where there studied clastic materials were sorted. The weathering intensity and plagioclase lixiviation revealed by the CIA and PIA indexes advocate a weak to intense strength of chemical weathering and lixiviation of plagioclase felspars while the CIX and PIX with elimination of CaO in their formulars show extreme intensity of weathering and lixiviation of plagioclase felspars.Most of the samples show immature nature from their ICV values > 1 but with the introduction of ICVnew in this work, where oxides of iron and calcite are considered as cement and eliminated from the formular show that all the studied samples have values

Introduction: This study aims to further characterize cannabidiol’s pharmacological and molecular profile as an antidepressant.Methods: Effects of cannabidiol (CBD), alone or combined with sertraline (STR), were evaluated in male CD1 mice (n = 48) exposed to an unpredictable chronic mild stress (UCMS) procedure. Once the model was established (4 weeks), mice received CBD (20 mg·kg-1, i.p.), STR (10 mg·kg-1, p.o.) or its combination for 28 days. The efficacy of CBD was evaluated using the light-dark box (LDB), elevated plus maze (EPM), tail suspension (TS), sucrose consumption (SC) and novel object recognition (NOR) tests. Gene expression changes in the serotonin transporter, 5-HT1A and 5-HT2A receptors, BDNF, VGlut1 and PPARdelta, were evaluated in the dorsal raphe, hippocampus (Hipp) and amygdala by real-time PCR. Besides, BDNF, NeuN and caspase-3 immunoreactivity were assessed in the Hipp.Results: CBD exerted anxiolytic and antidepressant-like effects at 4 and 7 days of treatment in the LDB and TS tests, respectively. In contrast, STR required 14 days of treatment to show efficacy. CBD improved cognitive impairment and anhedonia more significantly than STR. CBD plus STR showed a similar effect than CBD in the LBD, TST and EPM. However, a worse outcome was observed in the NOR and SI tests. CBD modulates all molecular disturbances induced by UCMS, whereas STR and the combination could not restore 5-HT1A, BDNF and PPARdelta in the Hipp.Discussion: These results pointed out CBD as a potential new antidepressant with faster action and efficiency than STR. Particular attention should be given to the combination of CBD with current SSRI since it appears to produce a negative impact on treatment.

Further investigation is needed to improve the identification and classification of fish in underwater images using artificial intelligence, specifically deep learning. Questions that need to be explored include the importance of using diverse backgrounds, the effect of (not) labeling small fish on precision, the number of images needed for successful classification, and whether they should be randomly selected. To address these questions, a new labeled dataset was created with over 18,400 recorded Mediterranean fish from 20 species from over 1,600 underwater images with different backgrounds. Two state-of-the-art object detectors/classifiers, YOLOv5m and Faster RCNN, were compared for the detection of the ‘fish’ category in different datasets. YOLOv5m performed better and was thus selected for classifying an increasing number of species in six combinations of labeled datasets varying in background types, balanced or unbalanced number of fishes per background, number of labeled fish, and quality of labeling. Results showed that i) it is cost-efficient to work with a reduced labeled set (a few hundred labeled objects per category) if images are carefully selected, ii) the usefulness of the trained model for classifying unseen datasets improves with the use of different backgrounds in the training dataset, and iii) avoiding training with low-quality labels (e.g., small relative size or incomplete silhouettes) yields better classification metrics. These results and dataset will help select and label images in the most effective way to improve the use of deep learning in studying underwater organisms.

Objectives The use of medications among pregnant women has been rising over the past few decades but the reporting of polypharmacy has been sporadic. The objective of this review is to identify literature reporting the prevalence of polypharmacy among pregnant women, the prevalence of multimorbidity in women taking multiple medications in pregnancy and associated effects on maternal and offspring outcomes.Design MEDLINE and Embase were searched from their inception to 14 September 2021 for interventional trials, observational studies and systematic reviews reporting on the prevalence of polypharmacy or the use of multiple medications in pregnancy were included.Data on prevalence of polypharmacy, prevalence of multimorbidity, combinations of medications and pregnancy and offspring outcomes were extracted. A descriptive analysis was performed.Results Fourteen studies met the review criteria. The prevalence of women being prescribed two or more medications during pregnancy ranged from 4.9% (4.3%–5.5%) to 62.4% (61.3%–63.5%), with a median of 22.5%. For the first trimester, prevalence ranged from 4.9% (4.7%–5.14%) to 33.7% (32.2%–35.1%). No study reported on the prevalence of multimorbidity, or associated pregnancy outcomes in women exposed to polypharmacy.Conclusion There is a significant burden of polypharmacy among pregnant women. There is a need for evidence on the combinations of medications prescribed in pregnancy, how this specifically affects women with multiple long-term conditions and the associated benefits and harms.Tweetable abstract Our systematic review shows significant burden of polypharmacy in pregnancy but outcomes for women and offspring are unknown.PROSPERO registration number CRD42021223966.

Abstract Background Although maternal death is rare in the United Kingdom, 90% of these women had multiple health/social problems. This study aims to estimate the prevalence of pre-existing multimorbidity (two or more long-term physical or mental health conditions) in pregnant women in the United Kingdom (England, Northern Ireland, Wales and Scotland). Study design Pregnant women aged 15–49 years with a conception date 1/1/2018 to 31/12/2018 were included in this population-based cross-sectional study, using routine healthcare datasets from primary care: Clinical Practice Research Datalink (CPRD, United Kingdom, n = 37,641) and Secure Anonymized Information Linkage databank (SAIL, Wales, n = 27,782), and secondary care: Scottish Morbidity Records with linked community prescribing data (SMR, Tayside and Fife, n = 6099). Pre-existing multimorbidity preconception was defined from 79 long-term health conditions prioritised through a workshop with patient representatives and clinicians. Results The prevalence of multimorbidity was 44.2% (95% CI 43.7–44.7%), 46.2% (45.6–46.8%) and 19.8% (18.8–20.8%) in CPRD, SAIL and SMR respectively. When limited to health conditions that were active in the year before pregnancy, the prevalence of multimorbidity was still high (24.2% [23.8–24.6%], 23.5% [23.0–24.0%] and 17.0% [16.0 to 17.9%] in the respective datasets). Mental health conditions were highly prevalent and involved 70% of multimorbidity CPRD: multimorbidity with ≥one mental health condition/s 31.3% [30.8–31.8%]). After adjusting for age, ethnicity, gravidity, index of multiple deprivation, body mass index and smoking, logistic regression showed that pregnant women with multimorbidity were more likely to be older (CPRD England, adjusted OR 1.81 [95% CI 1.04–3.17] 45–49 years vs 15–19 years), multigravid (1.68 [1.50–1.89] gravidity ≥ five vs one), have raised body mass index (1.59 [1.44–1.76], body mass index 30+ vs body mass index 18.5–24.9) and smoked preconception (1.61 [1.46–1.77) vs non-smoker). Conclusion Multimorbidity is prevalent in pregnant women in the United Kingdom, they are more likely to be older, multigravid, have raised body mass index and smoked preconception. Secondary care and community prescribing dataset may only capture the severe spectrum of health conditions. Research is needed urgently to quantify the consequences of maternal multimorbidity for both mothers and children.

With the advent of deep-learning (DL) techniques, image annotation has become a fundamental part of the research process. In the case of underwater image annotation, the human in charge of the task is faced whith the inherent quality problems of this kind of images. A large number of underwater image enhancement (UIE) methods have been developed aimed at improving the colors and contrast of these images. However, no attention has been paid to the specific problem of image annotation. In this case the global image quality of the processed image is less important than the fact that the objects to be annotated stand out and that their contours are easy to delineate. In this paper we evaluate seven state-of-the-art UIE techniques and rank them, through a subjective approach, according to their utility for the annotation process. The conclusion of our study is that, in general, the model-free Multiscale Retinex algorithm is preferred over more complex techniques that try to model the formation of the underwater images.

Introduction One in five pregnant women has multiple pre-existing long-term conditions in the UK. Studies have shown that maternal multiple long-term conditions are associated with adverse outcomes. This observational study aims to compare maternal and child outcomes for pregnant women with multiple long-term conditions to those without multiple long-term conditions (0 or 1 long-term conditions).Methods and analysis Pregnant women aged 15–49 years old with a conception date between 2000 and 2019 in the UK will be included with follow-up till 2019. The data source will be routine health records from all four UK nations (Clinical Practice Research Datalink (England), Secure Anonymised Information Linkage (Wales), Scotland routine health records and Northern Ireland Maternity System) and the Born in Bradford birth cohort. The exposure of two or more pre-existing, long-term physical or mental health conditions will be defined from a list of health conditions predetermined by women and clinicians. The association of maternal multiple long-term conditions with (a) antenatal, (b) peripartum, (c) postnatal and long-term and (d) mental health outcomes, for both women and their children will be examined. Outcomes of interest will be guided by a core outcome set. Comparisons will be made between pregnant women with and without multiple long-term conditions using modified Poisson and Cox regression. Generalised estimating equation will account for the clustering effect of women who had more than one pregnancy episode. Where appropriate, multiple imputation with chained equation will be used for missing data. Federated analysis will be conducted for each dataset and results will be pooled using random-effects meta-analyses.Ethics and dissemination Approval has been obtained from the respective data sources in each UK nation. Study findings will be submitted for publications in peer-reviewed journals and presented at key conferences.

In light of the 2021 United States military withdrawal from Afghanistan, as well as the humanitarian crises of mass displacement and subsequent health system strain that have ensued, practitioners worldwide will need to develop a more nuanced understanding of the adverse life experiences that women from Afghanistan frequently endorse. As they bear a disproportionate impact of constraints within Afghan society, and as patriarchal systems affect most of their life domains, women from Afghanistan may present with high levels of baseline trauma upon resettlement, and health systems may seek to attenuate this distress; However, the nature of these traumatogenic events may shape women's receptivity to psychosocial interventions, particularly those which are at least partially rooted in Western modalities. In the absence of sufficient literature on evidence-based interventions for this population, a diversity of ethnographic and clinical literature is synthesized, including literature on interventions alleged to be compatible with Afghan norms. As it will be essential to support Afghan women's mental health following social reorganization on a massive scale, considerations arising from the interdisciplinary literature are offered so that they may inform the development of structured, trauma-focused interventions and so that the health systems with which they interface may be better prepared to serve them.

ObjectivesThis study aims to assess the association between daily temperature and sickness absence episodes in the Mediterranean province of Barcelona between 2012 and 2015, according to sociodemographic and occupational characteristics.MethodsEcological study of a sample of salaried workers affiliated to the Spanish social security, resident in Barcelona province between 2012 and 2015. The association between daily mean temperature and risk of new sickness absence episodes was estimated with distributed lag non-linear models. The lag effect up to 1 week was considered. Analyses were repeated separately by sex, age groups, occupational category, economic sector and medical diagnosis groups of sickness absence.ResultsThe study included 42,744 salaried workers and 97,166 episodes of sickness absence. The risk of sickness absence increased significantly between 2 and 6 days after the cold day. For hot days there was no association with risk of sickness absence. Women, young, non-manual and workers in the service sector had a higher risk of sickness absence on cold days. The effect of cold on sickness absence was significant for respiratory system diseases (RR: 2.16; 95%CI: 1.68–2.79) and infectious diseases (RR: 1.31; 95%CI: 1.04–1.66).ConclusionLow temperatures increase the risk of having a new episode of sickness absence, especially due to respiratory and infectious diseases. Vulnerable groups were identified. These results suggest the importance of working in indoor and possibly poorly ventilated spaces in the spread of diseases that eventually lead to an episode of sickness absence. It is necessary to develop specific prevention plans for cold situations.

There is still limited understanding of how chronic conditions co-occur in patients with multimorbidity and what are the consequences for patients and the health care system. Most reported clusters of conditions have not considered the demographic characteristics of these patients during the clustering process. The study used data for all registered patients that were resident in Fife or Tayside, Scotland and aged 25 years or more on 1st January 2000 and who were followed up until 31st December 2018. We used linked demographic information, and secondary care electronic health records from 1st January 2000. Individuals with at least two of the 31 Elixhauser Comorbidity Index conditions were identified as having multimorbidity. Market basket analysis was used to cluster the conditions for the whole population and then repeatedly stratified by age, sex and deprivation. 318,235 individuals were included in the analysis, with 67,728 (21·3%) having multimorbidity. We identified five distinct clusters of conditions in the population with multimorbidity: alcohol misuse, cancer, obesity, renal failure, and heart failure. Clusters of long-term conditions differed by age, sex and socioeconomic deprivation, with some clusters not present for specific strata and others including additional conditions. These findings highlight the importance of considering demographic factors during both clustering analysis and intervention planning for individuals with multiple long-term conditions. By taking these factors into account, the healthcare system may be better equipped to develop tailored interventions that address the needs of complex patients.

Abstract Cancer incidence and survival rates have increased in the last decades and as a result, the number of working age people diagnosed with cancer who return to work. In this study the probability of accumulating days of employment and employment participation trajectories (EPTs) in a sample of salaried workers in Catalonia (Spain) who had a sickness absence (SA) due to cancer were compared to salaried workers with SA due to other diagnoses or without SA. Each individual with SA due to cancer between 2012 and 2015 was matched by age, sex, and onset of time at risk to a worker with SA due to other diagnoses and another worker without SA. Accumulated days of employment were measured, and negative binomial models were applied to assess differences between comparison groups. Latent class models were applied to identify EPTs and multinomial regression models to analyse the probability of belonging to one EPT of each group. Men and women without SA or with SA due to other diagnoses had at least a 9% higher probability of continuing in employment compared to workers who had a SA due to cancer, especially among men without SA (adjusted IRR 1.27, 95% CI 1.06‒1.53). Men without SA had the highest probability of having high stable EPT compared to workers who had a SA due to cancer (adjusted RRR 3.21, 95% CI 1.87‒5.50). Even though workers with SA due to cancer continue working afterwards, they do it less often than matched controls and with a less stable employment trajectory. Health and social protection systems should guaranty cancer survivors the opportunity to continue voluntary participation in the labour market.

Objective To develop international consensus on the definition and measurement of multimorbidity in research.Design Delphi consensus study.Setting International consensus; data collected in three online rounds from participants between 30 November 2020 and 18 May 2021.Participants Professionals interested in multimorbidity and people with long term conditions were recruited to professional and public panels.Results 150 professional and 25 public participants completed the first survey round. Response rates for rounds 2/3 were 83%/92% for professionals and 88%/93% in the public panel, respectively. Across both panels, the consensus was that multimorbidity should be defined as two or more long term conditions. Complex multimorbidity was perceived to be a useful concept, but the panels were unable to agree on how to define it. Both panels agreed that conditions should be included in a multimorbidity measure if they were one or more of the following: currently active; permanent in their effects; requiring current treatment, care, or therapy; requiring surveillance; or relapsing-remitting conditions requiring ongoing care. Consensus was reached for 24 conditions to always include in multimorbidity measures, and 35 conditions to usually include unless a good reason not to existed. Simple counts were preferred for estimating prevalence and examining clustering or trajectories, and weighted measures were preferred for risk adjustment and outcome prediction.Conclusions Previous multimorbidity research is limited by inconsistent definitions and approaches to measuring multimorbidity. This Delphi study identifies professional and public panel consensus guidance to facilitate consistency of definition and measurement, and to improve study comparability and reproducibility.

Plant reserves play a key role in woody perennial plant winter survival and growth resumption in the spring. In fruit crops, reserves are critical for production in temperate climates when nutrient uptake is minimal and photosynthate production is limited in newly emerged leaves. Fall nitrogen (N) fertilization can be used to increase the availability of plant reserves to support and enhance vegetative growth and fruit production the following growing season. The objective of this study was to test the effect of fall N fertilization on fruit production by evaluating yield components and their relationships to vegetative growth. A split-plot design was established in three ‘HyRed’ cranberry production beds at a farm in central Wisconsin in a 3-year study. Fall N treatments were the main effect and consisted of plots receiving a single application of 0%, 10%, 20%, and 40% of the standard N application (67 kg⋅ha–1) used during the growing season. Summer N fertilization treatments were split in five weekly applications as subplots and consisted of a complete (100%) and a balance (60%, 80%, and 90%) of the standard N application (67 kg⋅ha–1) used during the growing season. Yield was unaffected by either the fall or summer fertilization treatments, but there was an increase in berry weight and a reduction in the number of fruit per unit area using the 40% fall N fertilization treatment. The lower number of fruit per unit area resulted from an increase in the proportion of vegetative uprights—a phenomenon related to an increased length of uprights. Prolonged growth may have affected the flower bud induction window, which occurs in early fall. The fall N fertilization effect of increased vegetative growth may have been the result of an increased availability of N in spring. This result could be advantageous in the establishment of new beds or the recovery of vines that have experienced stress.